Volume 16, Number 4
 

A new course to improve the communication skills of oncology specialists

Pauline Leonard explains how the ‘Connected’ programme, recently launched by the National Cancer Action Team (NCAT), uses role play to develop the communication skills of senior front-line staff caring for patients suffering from cancer

A proposed algorithm on when to switch opioid

The increasing popularity of switching or rotating opioids in patients with moderate-to-severe cancer pain has led a London NHS trust to draw up guidelines, which incorporate a clinical decision-support alogrithm, to inform clinical practice. Kumaraja Wilkinson explains

FCP: why Italy is a special case when it comes to palliative care

Italy was a late starter in developing palliative care, but things are now changing rapidly. Nevertheless, the country seems to be unique among its European counterparts in still suffering from ‘opiumphobia’. Francesca Crippa Floriani, President of the Federazione Cure Palliative (FCP), explains what is being done for terminally ill patients and their families

Improving governance, knowledge management and teamwork in palliative care

In the multidisciplinary environment of palliative care, the key to improved efficiency – and therefore better patient care – lies in enhancing the structures and processes in three vital areas. Michael Lucey explains

Is it appropriate for doctors to take a spiritual history?

In the first of a series of articles on religious issues in palliative care by different authors, Joanne Sinclair reviews the literature on how doctors address their patients’ spiritual needs and looks at the professional responsibilities involved

Palliative care and Parkinson’s disease: a literature review

How are the palliative needs of patients with Parkinson’s disease being met? Dorry McLaughlin and Barbara Cochrane carried out a review of the literature and came to the conclusion that collaboration between specialties and services is needed

Principles of project management in palliative care

Rhidian Hughes and Robert Marshall consider the fundamentals of project management and how they can be applied to the palliative care setting, describing what lessons can be learned from following the recognised project management methodology ‘PRINCE2’

Returning meaning to palliative care staff

The search for meaning and values is a concern for all of us throughout our lives. However, it can become a discomforting preoccupation for palliative care nurses, for whom repeated contact with death and dying can lead to personal crisis. Clinical supervision is invaluable because it provides a structure of formal work discussions, and can help staff to maintain a safe work environment, with good teamwork and balance.

The case study masterclass: Case 44 answers. A recurrrent case of pseudomembranous candidosis

Mary, a 68-year-old woman with advanced metastatic carcinoma of the thyroid, has been admitted to the palliative care unit for symptom control. On admission she complains, among other things, of a ‘dry mouth’, with associated oral discomfort. Examination of the oral cavity reveals clinical features of salivary gland hypofunction (that is, dryness of the mucous membranes and no pool of saliva in the floor of the mouth) and of pseudomembranous candidosis (that is, confluent lesions on the dorsal surface of the tongue and discrete lesions on the remaining oral mucosa).

The case study masterclass: Case 45. Helping a young woman to fight the psychological side-effects of cervical cancer treatment

Sara is a 28-year-old woman who lives with her partner. Eighteen months ago, she underwent radical treatment, including chemoradiotherapy, for early-stage carcinoma of the uterine cervix. Six months ago, she started experiencing persistent abdominal and rectal pain and was admitted for an ileostomy to resolve her symptoms. This was performed nine days ago.

Treating pain associated with head and neck cancer

More than two-thirds of patients who have head and neck cancer experience pain. To treat it, you need to know what sort of pain it is and what is causing it. John E Williams and Jonathan TC Yen explain the system they use to manage such patients in their practice

Using sedation without the consent of the terminally ill

Anne-Marie Raftery and Carole Willard consider the arguments for and against using terminal sedation without the patient’s consent, and ask whether it can ever be regarded as an appropriate and ethically justifiable act to control distress in the context of end-of-life care

Working with emotion in palliative day care

The outward expression of feelings in the workplace brings both challenges and opportunities. Jacqueline H Watts shows how emotion work can help palliative care professionals to enhance their relationships with day-care patients